Angelique L Burke
Individual provider Active NPI Professional Counselor · Chamblee, GA
NPI 1023575552 · NPPES record last updated Feb 20, 2019
Key facts
- NPI
- 1023575552
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC005476 (GA)
- Practice address
- 3720 Chamblee Dunwoody Rd
Chamblee, GA 30341-2064 - Phone
- (404) 849-9100
- NPI assigned
- Feb 20, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC005476 | GA | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC005476 | GA | Yes |
Addresses
Primary practice location
3720 Chamblee Dunwoody Rd
Chamblee, GA 30341-2064
Mailing address
1444 Hawthorne Way
East Point, GA 30344-1749
Phone (404) 849-9100
Other practice location 1
1444 Hawthorne Way
East Point, GA 30344-1749
Phone (404) 849-9100
Other providers in Chamblee, GA
- Adrian Box
- Kimberly Brazis
- Sue A Brenner
- Tonia Louell Brightly
- Peter Sloane Bucci
- Carlos Javier Caraballo Guzman
- Care Plus Family Medicine, PC
- Caring Pharmacy LLC
- Cleveland Folashade Caulker
- Celestial Private Homecare LLC
All providers in Chamblee, GA · Professional Counselor in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.